PMID- 29680345 OWN - NLM STAT- MEDLINE DCOM- 20200318 LR - 20200318 IS - 1876-7591 (Electronic) IS - 1876-7591 (Linking) VI - 12 IP - 6 DP - 2019 Jun TI - Association Between Haptoglobin Phenotype and Microvascular Obstruction in Patients With STEMI: A Cardiac Magnetic Resonance Study. PG - 1007-1017 LID - S1936-878X(18)30276-6 [pii] LID - 10.1016/j.jcmg.2018.03.004 [doi] AB - OBJECTIVES: This study aimed to evaluate the correlation between different haptoglobin (Hp) phenotypes and myocardial infarction characteristics as detected by cardiac magnetic resonance (CMR) in consecutive patients after ST-segment elevation myocardial infarction (STEMI). BACKGROUND: Hp is a plasma protein that prevents iron-mediated oxidative tissue damage. CMR has emerged as the gold standard technique to detect left ventricular ejection fraction (LVEF), extent of scar with late gadolinium enhancement (LGE) technique, microvascular obstruction (MVO), and myocardial hemorrhage (MH) in patients with STEMI treated by primary percutaneous coronary intervention (pPCI). METHODS: A total of 145 consecutive STEMI patients (mean age 62.2 +/- 10.3 years; 78% men) were prospectively enrolled and underwent Hp phenotyping and CMR assessment within 1 week after STEMI. RESULTS: CMR showed an area at risk (AAR) involving 26.6 +/- 19.1% of left ventricular (LV) mass with a late LGE extent of 15.2 +/- 13.1% of LV mass. MVO and MH occurred in 38 (26%) and 12 (8%) patients, respectively. Hp phenotypes 1-1, 2-1, 2-2 were observed in 15 (10%), 62 (43%), and 68 (47%), respectively. Multivariable analysis demonstrated that body mass index, Hp2-2, diabetes, and peak troponin I were independent predictors of MVO with Hp2-2 associated with the highest odds ratio (OR) (OR: 5.5 [95% confidence interval [CI]: 2.1 to 14.3; p < 0.001]). Hp2-2 significantly predicted both the presence (area under the curve [AUC]: 0.63 [95% CI: 0.53 to 0.72; p = 0.008]) and extent of MVO (AUC: 0.63 [95% CI: 0.54 to 0.72; p = 0.007]). CONCLUSIONS: Hp phenotype is an independent predictor of MVO. Therefore, Hp phenotyping could be used for risk stratification and may be useful in assessing new therapies to reduce myocardial reperfusion injury in patients with STEMI. CI - Copyright (c) 2019 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. FAU - Pontone, Gianluca AU - Pontone G AD - Centro Cardiologico Monzino, IRCCS, Milan, Italy. Electronic address: gianluca.pontone@ccfm.it. FAU - Andreini, Daniele AU - Andreini D AD - Centro Cardiologico Monzino, IRCCS, Milan, Italy; Department of Cardiovascular Sciences and Community Health, University of Milan, Milan, Italy. FAU - Guaricci, Andrea I AU - Guaricci AI AD - Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital "Policlinico" of Bari, Bari, Italy; Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy. FAU - Guglielmo, Marco AU - Guglielmo M AD - Centro Cardiologico Monzino, IRCCS, Milan, Italy. FAU - Baggiano, Andrea AU - Baggiano A AD - Centro Cardiologico Monzino, IRCCS, Milan, Italy. FAU - Muscogiuri, Giuseppe AU - Muscogiuri G AD - Centro Cardiologico Monzino, IRCCS, Milan, Italy. FAU - Fusini, Laura AU - Fusini L AD - Centro Cardiologico Monzino, IRCCS, Milan, Italy. FAU - Fazzari, Fabio AU - Fazzari F AD - Department of Cardiology, University Hospital P. Giaccone, Palermo, Italy. FAU - Berzovini, Claudio AU - Berzovini C AD - Department of Surgical Sciences, Radiology Institute, University of Turin, Turin, Italy. FAU - Pasquini, Annalisa AU - Pasquini A AD - Department of Cardiology, "La Sapienza" University of Rome, Rome, Italy. FAU - Mushtaq, Saima AU - Mushtaq S AD - Centro Cardiologico Monzino, IRCCS, Milan, Italy. FAU - Conte, Edoardo AU - Conte E AD - Centro Cardiologico Monzino, IRCCS, Milan, Italy. FAU - Cosentino, Nicola AU - Cosentino N AD - Centro Cardiologico Monzino, IRCCS, Milan, Italy. FAU - Rabbat, Mark G AU - Rabbat MG AD - Loyola University of Chicago, Chicago, Illinois; Edward Hines Jr. VA Hospital, Hines, Illinois. FAU - Marenzi, Giancarlo AU - Marenzi G AD - Centro Cardiologico Monzino, IRCCS, Milan, Italy. FAU - Bartorelli, Antonio L AU - Bartorelli AL AD - Centro Cardiologico Monzino, IRCCS, Milan, Italy; Department of Biomedical and Clinical Sciences "Luigi Sacco," University of Milan, Milan, Italy. FAU - Pepi, Mauro AU - Pepi M AD - Centro Cardiologico Monzino, IRCCS, Milan, Italy. FAU - Tremoli, Elena AU - Tremoli E AD - Centro Cardiologico Monzino, IRCCS, Milan, Italy. FAU - Banfi, Cristina AU - Banfi C AD - Centro Cardiologico Monzino, IRCCS, Milan, Italy. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20180418 PL - United States TA - JACC Cardiovasc Imaging JT - JACC. Cardiovascular imaging JID - 101467978 RN - 0 (Biomarkers) RN - 0 (HP protein, human) RN - 0 (Haptoglobins) SB - IM CIN - JACC Cardiovasc Imaging. 2019 Jun;12(6):1018-1019. PMID: 29680354 MH - Aged MH - Biomarkers/blood MH - Coronary Circulation MH - Female MH - Haptoglobins/*analysis MH - Humans MH - *Magnetic Resonance Imaging, Cine MH - Male MH - Microcirculation MH - Middle Aged MH - Myocardial Reperfusion Injury/*diagnostic imaging/etiology/physiopathology MH - Myocardium/pathology MH - Percutaneous Coronary Intervention/*adverse effects MH - Predictive Value of Tests MH - Prospective Studies MH - Risk Factors MH - ST Elevation Myocardial Infarction/blood/diagnostic imaging/physiopathology/*therapy MH - Stroke Volume MH - Treatment Outcome MH - Ventricular Function, Left MH - Ventricular Remodeling OTO - NOTNLM OT - cardiac magnetic resonance OT - haptoglobin OT - microvascular obstruction OT - myocardial infarction EDAT- 2018/04/24 06:00 MHDA- 2020/03/19 06:00 CRDT- 2018/04/23 06:00 PHST- 2017/12/26 00:00 [received] PHST- 2018/03/06 00:00 [revised] PHST- 2018/03/07 00:00 [accepted] PHST- 2018/04/24 06:00 [pubmed] PHST- 2020/03/19 06:00 [medline] PHST- 2018/04/23 06:00 [entrez] AID - S1936-878X(18)30276-6 [pii] AID - 10.1016/j.jcmg.2018.03.004 [doi] PST - ppublish SO - JACC Cardiovasc Imaging. 2019 Jun;12(6):1007-1017. doi: 10.1016/j.jcmg.2018.03.004. Epub 2018 Apr 18.